33 Participants Needed

Sodium Thiosulfate for Chemotherapy-Induced Hearing Loss

SC
Overseen BySite Contact Cincinnati Children's Hospital Medical Center
Age: < 65
Sex: Any
Trial Phase: Phase < 1
Sponsor: Children's Hospital Medical Center, Cincinnati
Must be taking: Cisplatin, Sodium thiosulfate
No Placebo GroupAll trial participants will receive the active study treatment (no placebo)
Approved in 2 JurisdictionsThis treatment is already approved in other countries

What You Need to Know Before You Apply

What is the purpose of this trial?

This study will attempt to demonstrate the efficacy of Sodium Thiosulfate (STS) in preventing hearing loss in patients re-treated with cisplatin-based therapy according to regimens Cisplatin and STS (regimen CS) and Cisplatin, STS and Vorinostat/SAHA (regimen CSS).

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you must not have received myelosuppressive chemotherapy or immunotherapy within 2 weeks before joining the study. If you are on tacrolimus or sirolimus, your levels must be 10 ng/mL or lower.

Is sodium thiosulfate safe for humans?

Sodium thiosulfate has been studied for its ability to reduce hearing loss caused by certain chemotherapy drugs, like cisplatin, in children and adults. It has been approved in the USA for use in children to prevent hearing loss from chemotherapy, indicating it is generally considered safe for this purpose. However, in some animal studies, it showed potential neurotoxicity (harm to the nervous system) when administered immediately after certain treatments, suggesting timing of administration is important for safety.12345

How does the drug sodium thiosulfate differ from other treatments for chemotherapy-induced hearing loss?

Sodium thiosulfate is unique because it acts as an antioxidant that directly interacts with cisplatin, a chemotherapy drug, to prevent hearing loss without affecting its cancer-fighting ability. It is administered after chemotherapy and works by increasing antioxidant levels in cells, which helps protect against damage.12346

What data supports the effectiveness of the drug sodium thiosulfate for preventing chemotherapy-induced hearing loss?

Research shows that sodium thiosulfate can help prevent hearing loss caused by the chemotherapy drug cisplatin, especially in children with localized cancer. It works by neutralizing harmful effects of cisplatin without affecting its ability to fight cancer.12357

Who Is on the Research Team?

James Geller - Professor of Pediatrics ...

James Geller, MD

Principal Investigator

Children's Hospital Medical Center, Cincinnati

Are You a Good Fit for This Trial?

This trial is for patients aged 1 month to 39 years with hepatoblastoma or certain other cancers, who have previously responded to cisplatin but now show progression or resistance. They must have a life expectancy of at least 8 weeks, good organ function, and no severe side effects from previous treatments. Pregnant women and those with heart failure or uncontrolled illnesses are excluded.

Inclusion Criteria

I am not currently in another clinical trial or taking experimental treatments.
My cancer is one of the following types: hepatoblastoma, Wilms tumor, germ cell tumor, or neuroblastoma.
My liver tests are within the required range.
See 6 more

Exclusion Criteria

I have RTA with low bicarbonate and phosphate levels.
I am sexually active and not using birth control.
Lactating females who plan to breastfeed their infants
See 5 more

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants receive cisplatin-based therapy with Sodium Thiosulfate (STS) and possibly Vorinostat/SAHA for relapsed/refractory hepatoblastoma and other embryonal tumors

Up to 5 years

Follow-up

Participants are monitored for safety, prevention of hearing loss, and tumor response

Up to 5 years

What Are the Treatments Tested in This Trial?

Interventions

  • Sodium Thiosulfate
Trial Overview The study tests the effectiveness of Sodium Thiosulfate (STS) in preventing hearing loss when given alongside cisplatin-based chemotherapy. There are two regimens: CS (Cisplatin/STS) for those previously sensitive to cisplatin, and CSS (Cisplatin/STS/Vorinostat) for those who've shown progression on or resistance to cisplatin.
How Is the Trial Designed?
3Treatment groups
Experimental Treatment
Group I: Stratum 2B- Regimen CSSExperimental Treatment1 Intervention
Wilms tumor, GCT, Neuroblastoma
Group II: Stratum 2A- Regimen CSSExperimental Treatment1 Intervention
Cisplatin resistant or progressed on cisplatin after initial response (when given at first diagnosis)
Group III: Stratum 1- Regimen CSExperimental Treatment1 Intervention
Cisplatin sensitive/no progression on cisplatin (when given at first diagnosis)

Find a Clinic Near You

Who Is Running the Clinical Trial?

Children's Hospital Medical Center, Cincinnati

Lead Sponsor

Trials
844
Recruited
6,566,000+

Published Research Related to This Trial

In a phase 3 trial involving 125 children and adolescents undergoing cisplatin chemotherapy, sodium thiosulfate significantly reduced the incidence of hearing loss, with only 28.6% of participants in the sodium thiosulfate group experiencing hearing loss compared to 56.4% in the control group.
Sodium thiosulfate was found to be safe, with no serious adverse events attributed to its use, suggesting it could be a valuable protective treatment against cisplatin-induced hearing loss in pediatric cancer patients.
Effects of sodium thiosulfate versus observation on development of cisplatin-induced hearing loss in children with cancer (ACCL0431): a multicentre, randomised, controlled, open-label, phase 3 trial.Freyer, DR., Chen, L., Krailo, MD., et al.[2022]
Trans-tympanic injections of sodium thiosulfate (STS) gel were found to be safe for the middle and inner ears in patients undergoing cisplatin treatment for cancer, with no significant adverse effects reported.
While the average hearing loss was slightly less in treated ears compared to control ears (1.3 dB), the difference was not statistically significant, indicating that further research is needed to enhance the efficacy of STS in preventing cisplatin-induced hearing loss.
A randomized controlled trial to test the efficacy of trans-tympanic injections of a sodium thiosulfate gel to prevent cisplatin-induced ototoxicity in patients with head and neck cancer.Rolland, V., Meyer, F., Guitton, MJ., et al.[2022]
Sodium thiosulfate (STS) significantly reduces the risk of ototoxic effects in patients undergoing platinum-based chemotherapy, with a relative risk of 0.61, based on a meta-analysis of 4 studies involving 278 patients.
The use of STS did not lead to a significant increase in the risk of poor event-free survival or overall survival, suggesting it can be safely used to protect against hearing loss without compromising cancer treatment outcomes.
Association of Sodium Thiosulfate With Risk of Ototoxic Effects From Platinum-Based Chemotherapy: A Systematic Review and Meta-analysis.Chen, CH., Huang, CY., Lin, HH., et al.[2022]

Citations

Effects of sodium thiosulfate versus observation on development of cisplatin-induced hearing loss in children with cancer (ACCL0431): a multicentre, randomised, controlled, open-label, phase 3 trial. [2022]
A randomized controlled trial to test the efficacy of trans-tympanic injections of a sodium thiosulfate gel to prevent cisplatin-induced ototoxicity in patients with head and neck cancer. [2022]
Association of Sodium Thiosulfate With Risk of Ototoxic Effects From Platinum-Based Chemotherapy: A Systematic Review and Meta-analysis. [2022]
Sodium Thiosulfate: Pediatric First Approval. [2023]
Interventions for cisplatin-induced hearing loss in children and adolescents with cancer. [2023]
In vitro and animal studies of sodium thiosulfate as a potential chemoprotectant against carboplatin-induced ototoxicity. [2015]
First evidence of otoprotection against carboplatin-induced hearing loss with a two-compartment system in patients with central nervous system malignancy using sodium thiosulfate. [2022]
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